Symptoms of Common Variable Immunodeficiency

Common variable immunodeficiency (CVID) is a disorder affecting the immune system that reduces your ability to fight infections. The hallmark of CVID is recurrent or severe infections.

Common symptoms can include chronic cough, runny nose, fatigue, fever, diarrhea, and swollen glands or lymph nodes. Exact symptoms will differ based on which type of infection a person has (respiratory vs. gastrointestinal) and which complications of CVID are present and their severity.

Learn more about the frequent and less common symptoms of CVID, and complications associated with the condition.

Frequent Symptoms

CVID symptoms are caused by unusually low levels of the antibodies that protect us from infections. As a result, a person with this condition is more likely to get sick, and these illnesses are more likely to be severe.

The primary symptom of this disease is recurrent viral or bacterial infections. Research shows that over 90% of people with CVID have increased susceptibility to infections of the upper airway, sinuses, lungs, or gastrointestinal tract, making this the most common sign of the disease.

Symptoms will differ depending on what type of infection a person is currently facing. Symptoms may wane at times, like during the recovery stage, or worsen when a person has one or more active infections.

Some of the most commons symptoms of these infections include:

• Chronic cough
• Cough resulting in yellow, green, or brown phlegm, or mucus
• Runny nose
• Swollen glands or lymph nodes
• Wheezing or other breathing issues
• Fever
• Ear pain
• Diarrhea
• Weight loss
• Nausea or vomiting
• Food nutrient deficiencies

Note that these symptoms are also commonly found in the general population when they have a cold, flu, or stomach bug. Therefore, you or your physician may not initially make the connection between these symptoms and the underlying cause of CVID.

The key difference is the frequent recurrence of infections associated with CVID. You may have a lingering cold or cough that sticks around for months, or you may have constant ear infections or bouts of diarrhea.

Over time, you may also notice that these symptoms of infection get worse and cause other complications.

Rare Signs and Symptoms

There are some rare signs and symptoms associated with CVID to look out for. These include disorders that may be diagnosed along with CVID or that lead to a diagnosis of CVID.

Joint Symptoms

About 1%–10% of people with common variable immunodeficiency will have joint symptoms that, at first glance, appear like rheumatoid arthritis. These exact symptoms can include joint swelling, stiffness, pain, and deformity.

In some cases, this arthritis is due to an infection in the synovial fluid of the joints and not due to the autoimmune process that occurs in rheumatoid arthritis.

Autoimmunity

It is estimated that about 30% of people with CVID have some form of autoimmunity. Autoimmunity is when the body's immune system malfunctions and attacks areas of the body by mistake. At this time, it is unclear if autoimmunity is a precursor to or a symptom of CVID.

Some CVID-associated autoimmune disorders include:

• Autoimmune thrombocytopenic purpura
• Autoimmune hemolytic anemia
• Neutropenia
• Pernicious anemia
• Autoimmune thyroiditis
• Inflammatory bowel disease
• Diabetes mellitus
• Multiple sclerosis
• Vitiligo
• Psoriasis

Liver Symptoms

Around 10% of people with CVID will present with either liver disease or have abnormal liver function tests.

In the majority of cases, the liver continues to function but the person may develop portal hypertension. This is an increased blood pressure in the veins connecting the digestive system and the liver.

Complications

Complications are common with CVID. It is essential that they are managed promptly and properly, because they can make the condition more dangerous.

CVID may be diagnosed in anyone over the age of 2 years old, but it's often not diagnosed until a person is in their 30s or 40s. Unfortunately, by this point, a person may have already developed some complications as a result of recurrent infections.

Possible complications of CVID include:

• Bronchiectasis: Recurrent lung infections or pneumonia can cause bronchiectasis, which is considered an obstructive lung disease. Bronchiectasis results in a permanent widening of the bronchi (which carry air to the lungs) and bronchioles (which carry air to alveoli, small air sacs in the lungs), which can complicate treatment for CVID.
• Granulomas: Severe infections, particularly lung infections, can lead to granulomas. This occurs in 10%–20% of cases and significantly worsens the prognosis. Granulomas are lumps of inflamed tissue. In CVID, they are typically seen in the lungs or lymph nodes, but can also be found in decreasing frequency in the skin, spleen, bone marrow, gastrointestinal tract, brain, or kidney.
• Poor response to vaccines: As a result of a dampened immune system, people with CVID can fail to develop adequate immunity from some vaccines. They have decreased ability to create immunoglobulins required for long-lasting immunity. As a result, certain live vaccines are contraindicated for those with this condition. However, research shows that the T-cell response is often normal, meaning that some immunity can still be gained from vaccines.
• Cancers: People with CVID have a greater risk of developing cancer, particularly lymphoma. Stomach and other gastrointestinal cancers are also found at a higher rate in people with CVID.
• Life expectancy: Certain CVID complications are associated with a lower life expectancy.

When to See a Doctor

If you are constantly feeling sick, you may want to talk to your physician about common variable immunodeficiency. Long-term illnesses may include a nagging cold, waking up every morning with a phlegmy cough, frequent stomach flu, or bouts of increasingly severe respiratory infections like pneumonia that bring you to urgent care or the hospital.

A physician will order blood tests to determine your immune system function. Certain lab test irregularities may cause your physician to refer you to a hematologist or immunologist to look further into the issue. These can include vitamin deficiencies, low platelet or white blood cell counts, and immunoglobulin deficiencies.

A Word From Verywell

It can be challenging to differentiate CVID symptoms from symptoms commonly found in people with a cold or the flu. Remember that the main warning sign, particularly in younger people, is the recurrence of infections and their symptoms, rather than the severity of these symptoms.

It is not normal to be sick all the time. If your frequent illnesses are impacting your daily life, functioning, and well-being, then make an appointment with your physician to discuss the issue.